Biomedical subjects

E Escudier

Publications and source records attributed to E Escudier.

61 records · Page 4Linked to original sources

PubMed1986

[Infections of the central nervous system in malignant hemopathies].

Central nervous system (CNS) infections in immunocompromised hosts are often accompanied by subtle disorders because immunosuppression usually decreases the inflammatory response. CNS infections in immunocompromised patients are usually caused by organisms different from those found in the general population. The organism causing CNS infection in an immunocompromised host can often be predicted if the type of immune abnormality of the patient is known. The common causes of CNS infection in immunocompromised hosts are reviewed here. Meningitis in patients with neutropenia is usually due to enteric Gram negative bacilli that live in the patient's own digestive tract. Pseudomonas aeruginosa is most common and is followed by E. Coli, Klebsiella, Enterobacter and Proteus. A major risk in patients with abnormal immunoglobulins or splenectomy is infection with encapsulated bacteria, particularly Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis. Meningitis caused by any of the encapsulated bacteria can be fulminant. Listeria monocytogenes is the most common cause of bacterial meningitis in patients with impaired cellular immunity. Nocardia asteroides is a leading cause of brain abscess in patients with hematologic malignancy. Most patients have evidence of concomitant pulmonary lesions. Fungi are among the most common organisms involving the CNS in immunocompromised hosts. Susceptible patients include those with lymphoma or leukemia and those who receive therapies aimed at suppressing delayed hypersensitivity. Cryptococcus neoformans is a common fungal cause of CNS infection in immunocompromised hosts. The primary site of infection is the lung. Spread to the CNS is via the blood stream. The clinical course is highly variable: meningitis, meningoencephalitis and focal mass lesions. Candida causes meningitis or meningoencephalitis characterized by multiple small abscesses in neutropenic hosts. Organisms reach the CNS via the blood stream usually from the digestive tract or infected intravenous catheters. Aspergillus causes brain abscess, cerebral infarction and focal meningitis in patients with neutropenia. The primary infection is in the lung. The parasites that infest the CNS of immunocompromised patients are usually those that exploit a T-lymphocyte, mononuclear phagocyte host defect. The most common are Toxoplasma gondii and Strongyloides stercoralis. There have been a few cases of amebiasis with dissemination to the brain in patients with hematologic malignancies. Toxoplasma gondii causes major CNS disease in immunocompromised hosts: meningoencephalitis or mass lesions.(ABSTRACT TRUNCATED AT 400 WORDS)

Bacterial Infections↗

PubMed1985

Ultrastructural abnormalities of respiratory cilia. Descriptive and quantitative study of respiratory mucosa in a series of 33 patients.

Ultrastructural abnormalities of human respiratory tract cilia have been studied in 33 patients: 21 were adults, 18 with chronic bronchitis, and 12 were children, two with situs inversus. Abnormalities, such as the lack of a few dynein arms or the loss of a peripheral doublet were observed quite frequently in both children and adults. However, congenital abnormalities associated with the "immotile cilia syndrome" were rare and were observed in only three of the children and none of the adults.

Adolescent↗

PubMed1985

[Incidence of ciliary beats in nasal cells obtained from smears. Study of 40 patients of whom 28 were children with respiratory pathology].

Disturbance of ciliary function are considered as a significant factor in the outcome of chronic respiratory afflictions. Thanks to a simple method of stroboscopic lighting, the ciliary beat frequency was studied on 40 nasal mucus smears obtained by swabbing in 28 children and 12 adults with chronic respiratory failure or recurrent disease. The 28 children were divided into three groups: group A (n = 10), pulmonary disease (broncho-pneumonia); group B (n = 3), Kartagener syndrome; group C (n = 15) pure otorhinolaryngological (ORL) disease (rhino-opharyngitis, sinusitis, otitis). Twelve adults with chronic ORL pathology (vaso-motor rhinitis) made up group D. A cytological control was carried out on each smear and showed the presence of ciliated cells in 92.5% of samples. In three group B cases (Kartagener's syndrome) no ciliary movement was observed. The results in groups A (9.3 +/- 1.46 Hz) and C (8.98 +/- 2.23 Hz) show that the level of respiratory infection (pulmonary or ORL) did not influence the ciliary beat frequency (p greater than 0.05). On the other hand, there was a significant difference (p less than 0.001) between the beat frequency in the group of children in group A (9.3 +/- 1.46 Hz) and C (8.98 +/- 2.23 Hz) and those of adults in group D (11.32 +/- 1.89 Hz). Two hypotheses might explain these facts: The existence of a differing physiological response in children and adults. Different mechanisms during chronic ORL infections in adults (vasomotor phenomena) and in the child (bacterial infection). The average frequencies measured were comparable to those previously published in human respiratory cilia using other methods.(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗

PubMed1984

[Stroboscopic study of the respiratory mucosal ciliary beat frequency].

Abnormalities of the ciliary function have been found as an important factor in chronic respiratory diseases. For the study of the ciliary beat frequency, we developed a stroboscopic method using a stroboscopic illuminator ( Strobo Hertz) substituted to the normal light of an inverted optic microscope (Leitz). The ciliated cells obtained either by nasal scraping or tracheobronchial brushing were maintained in a culture medium (IP 199) at 37 degrees C. The ciliary beat frequency was measured at various times, at least one hour after the sampling. Nasal scraping, was performed with a curette in 17 children from 10 months to 16 years who complained of chronic respiratory diseases. Ciliated cells were obtained in 14 samples. In one of them 5 years old with a situs inversus, although the ciliated cells were numerous, the cilia appeared immotile. In the 13 others, the frequency was from 7 to 11.5 Hz with a mean of 10.8 Hz. These results were compared to those obtained by tracheobronchial brushings performed in 7 patients from 4 months to 46 years who underwent an endoscopic investigation. The ciliary frequency was 7 to 10 Hz with a mean of 8.5 Hz. The study of the ciliary beat frequency obtained by nasal scraping seems to be a reliable method for the detection of abnormal ciliary function. Nasal scraping is a non invasive method. Moreover, the stroboscopic method is a non expensive tool.

Adolescent↗

PubMedDate not supplied

Distribution of lysozyme and mucin (MUC2 and MUC3) mRNA in human bronchus.

Immunocytochemical studies have shown that gel-forming glycoproteins (mucins) and the bacteriolytic protein lysozyme are selectively expressed in airway mucous and serous cells, respectively. The mechanisms mediating this selectivity are unknown. In this study, we localized mucin and lysozyme mRNA by in situ hybridization to investigate the possibility that phenotype-specific expression of these proteins is controlled at the level of mRNA. Radiolabelled sense and antisense probes were constructed from the human tracheal mucin cDNA, HAM1 (MUC2 gene), the human small intestinal mucin cDNA, SIB139 (MUC3 gene), and the bovine tracheal lysozyme cDNA, Lys 7a. Frozen sections of human bronchus were hybridized with these probes and washed under routine conditions. Autoradiography showed that although lysozyme mRNA was strictly limited to cells expressing lysozyme, mucin mRNA was present both in mucin-expressing and mucin-non-expressing epithelial cells. This suggests that the restriction of lysozyme to serous cells is controlled at the level of mRNA (synthesis and/or degradation), whereas the restriction of mucin to mucous cells is controlled at the level of translation.

Blotting, Northern↗

PubMedDate not supplied

The effects of cytocentrifugation on differential cell counts in samples obtained by bronchoalveolar lavage.

Quantification of the differential cell count and total number of cells recovered from the lower respiratory tract by bronchoalveolar lavage is a valuable technique for the diagnostic study of interstitial lung diseases. To examine the effect on the cell counts of different methods of processing the lavage fluid, two comparisons were performed. First, two methods of differential cell counting were compared using 28 fluids. One count was performed in a Malassez hemocytometer after incubation of the living cells with neutral red for five minutes at room temperature; large cells and some small cells that had incorporated neutral red were identified as macrophages. Another count was performed on cytocentrifuge preparations made using the Shandon Cytospin I and Cytospin II and stained by the May-Grünwald-Giemsa method. The percentage of cells identified as lymphocytes was significantly lower on the cytocentrifuge preparations than with the Malassez hemocytometer. In the second study, the differential cell counts on smears prepared by the two types of cytocentrifuge (Cytospin I and Cytospin II) were compared for 32 bronchoalveolar lavage fluids. The percentage of small cells (especially lymphocytes) was lower on preparations made with the Cytospin I than on those made with the Cytospin II, but the difference was not significant. The results indicate that (1) cytocentrifugation of bronchoalveolar lavage fluids does result in a significant loss of small cells, especially lymphocytes, and (2) this loss is not significantly lessened by the use of the Cytospin II.

Bronchoalveolar Lavage Fluid↗

PubMedDate not supplied

Cell population obtained by bronchoalveolar lavage in Pneumocystis carinii pneumonitis.

In the course of bronchoalveolar lavages performed in 115 immunocompromised patients in order to investigate the occurrences of pneumonitis, Pneumocystis carinii pneumonia was diagnosed by demonstration of cysts in bronchoalveolar lavage specimens from 11 patients. The cellular phenomena associated with P. carinii infection at the level of the alveolar space were evaluated. Differential cell counts on bronchoalveolar lavage preparations stained by the May-Grünwald-Giemsa method were performed in immunocompromised patients and in ten nonimmunocompromised patients without any respiratory disease. A decrease in the alveolar macrophage count associated with an increase in the polymorphonuclear neutrophil count and the presence of plasma cells and/or immunoblasts was highly suggestive of P. carinii pneumonia. These cellular changes in bronchoalveolar lavage specimens are discussed in relation to the pathologic features usually described in P. carinii pneumonia.

Adult↗